Thursday 7/6 - biopsy results: inconclusive


Still on the search...
  • Unfortunately, there was not enough tissue in the biopsy sample to make a definitive diagnosis. This happens with around 20% of needle biopsies and means we will have to do an open biopsy for further investigation - scheduled: Monday, July 17th.
  • Open biopsies are a more involved procedure but still routine: Dr. F and his residency orthopedic team do about 4 per week.  
  • If the tumor is benign (this will be established on site during the biopsy), they will go forward with the operation: scraping out the tumor and, if necessary, doing a bone graft. If successful, this would likely be the end of treatment!! It would probably mean just 4-6 weeks on crutches and then follow-up tests to be safe- so yes, a wonderful and not too unlikely scenario.
  • If the tumor is malignant, they will end the operation after the biopsy and next steps will be determined based on the tumor type.
What we do know
  • In the meantime, Dr. F's best guess is still chondroblastoma (when pushed, he said ~80% likelihood) and, consistent with this hypothesis, there was cartilage tissue in the sample - which is what chondroblastoma produces.
  • The weight loss and occasional chest pains, however, are not as consistent with it being benign- which, especially given that chondroblastoma can (in rare cases) spread to the lungs, gives us a bit of pause. I'll be following up today to ask about potentially getting a chest CT-scan.
  • Still, based on my symptoms and age, Dr. F reiterated that even if it is cancer, it is almost definitely primary: he is "not at all concerned" about it having spread from elsewhere in the body. So yes, all this sounds pretty good... and pretty familiar: about the same place we were in before the biopsy! 
  • Anyway, here's hoping for biopsy round 2! 🏁

Comments

Post a Comment

Popular posts from this blog

Tuesday 7/25 - pathology & prognosis

The tumor has been identified as chondroblastic osteosarcoma;  not one of the 3 we had expected from the initial report. It does create cartilage ("chondroblastic") which is why it was difficult to identify but it's actually a form of primary bone cancer ("osteosarcoma"). This is of course not the news we were hoping for, but we had some additional tests yesterday and determined that it is localized, i.e., has not metastasized or spread to other parts of the body! If those tests had not been clear, there would be very little chance of survival, so this was a HUGE relief. Dr. W, the surgeon covering for Dr. F during his vacation, explained that the cure rate for a localized osteosarcoma at my age is ~70-75%. It is generally somewhat lower chances for osteosarcoma in the hip bone, but he said mine is also smaller than most, so it may balance out to around the same odds. As he emphasized, the key being: the majority of cases are cured. (We will get throug...
Read more

Wednesday 11/15 - Surgery Initial Report (Success)

Francis here. A long day for all of us but mostly a blink for Jane. She is awake and groggy as she rests in the ICU, where she (and I) will remain the night for monitoring before moving to a regular room tomorrow to recover. We spoke briefly to several of the surgeons and everything went well and as planned. The tumor has been removed as well as a good chunk of the left hip. The hip joint has been replaced with a metal one and the hip bone that was removed replaced with bone-bank hip. It was almost exactly 12 hours from when she went into the OR at about 9:25 am this morning til she came out at a little before 9pm, with most of that time spent on careful reconstruction of the removed tissue and bone. For now Jane feels pretty funny from the numbness of the epidural and lingering traces of anesthesia, but she doesn't really have pain and is quite stable. Hopefully she can get some restful sleep tonight. We're feeling very blessed and grateful to have such good support here a...
Read more

Tuesday 11/21 - Surgery Recovery Update

Image
Hello, Francis again. Jane continues her recovery at Johns Hopkins. She was one night in the ICU after surgery for closer monitoring then moved to a normal hospital room, where she has resided since. All things considered, so far the recovery has gone quite well. She has had pain, especially as medicines have been changed and new equilibria reached, but it was a major surgery and so some pain is pretty unavoidable (one doctor actually mentioned that this surgery was basically the largest orthopedic surgery they do!). Yesterday was a big day. The epidural was removed as well as the intravenous pain medicine pump - she went from two pain buttons to push to zero. Her pain meds are all oral now, which is good because that is what she will go home with. She also had her first physical therapy yesterday; after being on bed rest and horizontal for 5 days, she sat up (with assistance) on the side of the bed. This activity, combined with the changing of the meds, caused a brief period of pret...
Read more